Second Cancer Risks following Retinoblastoma The cohort of 1,600 Retinoblastoma (RB) patients has been expanded to include 400 RB patients treated between 1996 through 2006 in order to evaluate the risk of second cancers following newer treatments for RB. Mortality from second cancer continues to be increased in hereditary RB patients, but not in patients with the non-hereditary form. Cancer Risks in Family Members of Ataxia-Telangiectasia Patients An international workshop organized by NCI was held with investigators from the UK, France and four Nordic countries to discuss pooling data to investigate cancer incidence in family members of ataxia-telangiectasia patients. Data are currently being formatted for pooled analyses. Cancer Mortality and Incidence Risks in Patients with Scoliosis A multi-center retrospective cohort study of 5,573 women who were monitored with diagnostic x-rays for their scoliosis found that they were 70% more likely to die from breast cancer than women in the general population. Analyses of all cause and cancer mortality are currently underway. Cancer Mortality following Multiple Chest Fluoroscopies for Tuberculosis Three cohorts of Massachusetts tuberculosis patients are being studied for cause-specific mortality through 2002, including cancer, in relation to radiation exposure from multiple chest fluorscopies received during adolescence and early adult life. Overall, we found little evidence of positive association between radiation dose and risk of lung cancer. These results were presented at June 2008, Radiation and Health Conference in Vail, Co. New Malignancies Among Cancer Survivors: SEER Cancer Registries, 1973-2000 A monograph was published describing the risk of new malignancies that have arisen among more than 2 million cancer survivors for the 27-year period 1973 to 2000, utilizing data from NCI"s SEER Program. The risks of subsequent cancers are systematically examined for more than 50 adult and 18 childhood tumors by gender, age at diagnosis of the initial cancer, and time since diagnosis, as well as the initial treatment and histologic type of certain cancers. Secondary Cancers of the Brain, Breast, and Thyroid Among Childhood Cancer Survivors Nested case-control studies of second primary cancers of the brain, breast, thyroid gland, salivary gland, bone, soft tissue and skin following an initial childhood cancer are being conducted within a cohort of more than 14,000 5-year survivors of childhood cancer to evaluate the relationship between radiation and chemotherapy treatment of childhood malignancies and risk of these second primary malignancies. Detailed radiation dosimetry was completed for the studies of second primary thyroid, brain, breast, bone and soft tissue cancer, and is in progress for the skin cancer study. Michael Reese Hospital Study Data from a cohort of children irradiated in childhood as treatment for enlarged tonsils and other benign head and neck conditions continues to be analyzed to provide information on radiation cancer risks and the clinical aspects of radiation-related tumors. Pediatric CT Scans Over the last two decades, the use of computed tomography (CT) scans has become widespread. It is estimated that 2-3 million CTs are performed annually on children and adolescents in the U.S. Working with collaborators from the University of Newcastle on Tyne, the Radiation Epidemiology Branch initiated an epidemiological cohort study to evaluate the potential risk of cancer associated with radiation exposure from pediatric CT scans. Cancer Risks following Use of Diagnostic and Therapeutic I-131 for Hyperthyroidism The Branch is evaluating the risk of cancer following diagnostic and therapeutic Iodine-131 in several study populations. Cancer mortality is being updated for a US cohort of 35,000 hyperthyroid patients treated with I-131, surgery, anti-thyroid drugs or combination therapy. Cancer incidence and mortality are currently being updated in 10,000 Swedish hyperthyroid patients treated with I-131 and a comparison group of 6,000 hyperthyroid patients who were not treated with radio-iodine. Cancer Mortality Among Women Treated with Radiotherapy for Benign Gynecologic Disease Cancer mortality following radiation treatment for benign gynecologic disease in a cohort of nearly 15,000 women is being updated to evaluate solid tumor risk. Radiation Risks from Interventional Fluoroscopy In collaboration with 5 medical societies of physicians who perform interventional procedures, a study of cancer mortality is being conducted. Additional data have been obtained from the American Medical Association to increase the number of interventional physicians to be evaluated, evaluate cancer mortality in radiologists, and provide a comparison group of physicians. A review of the literature was conducted to estimate the radiation doses to cardiologists performing cardiac catheterization procedures. Radiation Dose-Response and Second Primary Cancers of the Stomach, Pancreas and Esophagus An international study of three highly lethal GI malignancies is being conducted among cancer survivors of Hodgkin lymphoma, and testis, breast and cervical cancer that have been reported to population-based cancer registries. The major study objectives are to provide new quantitative information on radiation dose and the subsequent risk of stomach cancer, esophageal cancer, and pancreatic cancer; to evaluate the possible influence of age and chemotherapy; and to generate new data on the long-term temporal patterns of radiation-related GI cancers. In addition, available biologic samples will be collected to identify patterns of genomic aberrations in radiotherapy-induced second cancers. Radiation & Brain tumors: A pooled analysis While ionizing radiation is one of the few well-established risk factors in the etiology of CNS tumors, many issues of radiation effects remain unresolved due to insufficient data in individual studies. We suggest a broad pooling of data from radiation exposed populations aiming at more accurate quantification of the dose-response relationship and stronger power to assess the influence of age at exposure, temporal patterns of risk in terms of attained age and time since exposure, the effects of gender and fractionated exposures. We are conducting a literature review of what studies might be eligible for the pooling and assessing feasibility. Cancer Following Bone Marrow Transplantation 24,011 patients worldwide, treated with allogeneic bone marrow transplants are being evaluated for increased risk of all cancer related to the late effects of total-body medical irradiation (8-15 Gy), and severe immunosuppression. Treatments resulting in severe immune dysfunction, such as T-cell depletion of the donor bone marrow, were linked to high risks of post-transplant lymphoproliferative disorders. Conditioning regimens containing total body irradiation were associated with increased risks of solid tumors, with new findings showing an increased risk of breast cancer among long-term survivors.